The State of Missouri Office of Administration, Division of Purchasing, has issued RFP STATE 0000000557SL on behalf of the Department of Commerce and Insurance for Medical Care Utilization Review Services supporting Missouri’s external medical-review program. The solicitation was posted August 27, 2026. Amendment 01, published September 16, 2026, extended the response deadline to September 30, 2026 at 2:00 PM Central Time. The state has not published a contract value in the public notice. The work includes independent medical-utilization/external review, written clinical determinations, expedited review capability, reporting and quality/compliance support. Historical workload information in the reviewed solicitation materials indicates approximately 70 external-review cases per year.
Responses must be submitted electronically through MissouriBUYS, powered by MOVERS, and suppliers must be registered in that system. Reviewed solicitation materials require an appropriately qualified independent review organization, a physician Medical Director, at least two full-time registered-nurse reviewers, access to additional specialty clinicians as needed, applicable utilization-review registration/accreditation, conflict-of-interest safeguards, HIPAA/HITECH Business Associate compliance, E-Verify and state-required certifications. The current solicitation package includes the amended RFP, a Licensed Medical Personnel Areas of Specialty attachment and a Business Associate Agreement. Routine written reviews are generally due within 20 calendar days and expedited reviews within 72 hours, with quarterly meetings and annual statistical reporting also identified. No grant-style non-Federal match or cost share applies. Buyer: Ariel Bradford, 573-751-2497, Ariel.Bradford@oa.mo.gov. Vendors must check the live MissouriBUYS solicitation for any later addenda, amendments, Q&A or revised forms before submission.
Atlas Opportunity Score: 73/100. N9+ Fit: 0/100. QC Healthcare / other Dr. Miltie fit: 15/100 conditional. This is a legitimate healthcare-services procurement, but the required independent-review accreditation, Missouri utilization-review registration, physician Medical Director, nurse-review staffing and related experience have not been established in available Dr. Miltie records. Dr. Miltie, LLC should not respond directly unless every mandatory qualification can be independently documented. Nonagon N9+ is not a legitimate fit for the utilization-review scope.